When is it Time to Find Placement For a Loved One?

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Having worked in this field for 23 years, I have learned the recurring traits of the family member looking for placement. It is usually a caregiver in a crisis situation. "Mom is in the hospital and they are discharging her today." Prior, there has been many warnings. Spouses and family members tell the loved one that they will never "put them in a home" and are trying to keep the promise that they made. This is usually at the expense of the caregiver themselves either through declining health or sheer mental exhaustion.

If you answer yes to most of these questions, start looking for placement:

• Has your health declined as a result of caring for your loved one?
• Is there more one on one attention than you can keep up with?
• Has your loved one ever left the stove on or water running?
• Has your loved one ever wandered from home and gotten lost?
• Have there been repeated trips to the hospital?
• Do you ever lose your cool with your loved one?
• Are you spending more money than it would take in long term placement?
• Is your loved one refusing to eat, bathe, or any other activities of daily living (ADL's)?

If you answer no to most of these questions, start looking for placement:

• Is the environment stress free, allowing less agitation?
• Is my loved one getting the proper socialization? ie: church groups, outings, social interaction?
• Are you keeping up with your daily duties with spouse, kids and career while meeting the needs of your loved one?
• Are you able to physically lift your loved one while toileting or bathing them?
• Do you have time set aside each day for exercise and fun together?
• Do you set aside time each day for yourself?
• Do you supply programs that give them back choices?
• Do you know the skills of redirecting frustrations during an agitation episode?
• Is my loved one compliant with medications and diets?
• Are you able to keep them busy all day, allowing better eating and sleeping patterns?
• Do you feel your loved one has a sense of accomplishment at the end of the day? Ie: a feeling of still being needed?

Having been a caregiver myself in the early 80's, I am well aware of the promises made verses what is right for the individual in need. Sometimes you have to step back and look honestly at the quality of life that the loved one is receiving and if you cannot deliver all that is needed and you are at your wits end on what to do next, you owe it to yourself to become educated to long term care options.

For my own grandmother, the social aspects worked wonders. The whole time I was trying to care for her, it never occurred to me that her non-compliance to diet and hygiene would all change once she was around others with similar needs and in a structured environment. Be careful not to isolate your loved one while trying to do all that is required of you. It is easy to do. Many residents that come into my campus have been at home watching TV most of the day, causing them to eat poorly and sleep sporadically all day which then keeps them from sleeping at night. Make sure there is plenty of exercise even if they are in a wheelchair. Stretching and proper breathing throughout the day is very beneficial.

What to ask when visiting

When you visit a facility, make sure to ask for the latest state survey results. These should be readily available in the lobby area. Check for happiness and cleanliness of the staff as well as the residents. Make sure they do specialized programs if they advertise that they do. You should be able to come "unannounced". If they require an appointment, it is a red flag. Speak with several residents and ask them what makes them happy there and ask for a tour of the rooms and common areas. Your gut will tell you if there is a good feeling vs. a bad feeling of the place in question. Before you leave, you will want to meet both the Administrator and the Director of Nursing so you can ask more detailed questions regarding your loved ones specific needs.

Getting more specific

Most usually cost is a factor when looking for the right facility. You will want to make sure you're getting the most for your dollars. One facility may boast lower prices but in fact, only offer the bare essentials such as meals, utilities, a few activities (non specific to multiple needs), and housekeeping. A good indication that a facility cares is when they do things not expected such as having Nurses on-site 24/7, backed up by Med Techs, linen service, personal laundry included, and specialized programs for the different levels of memory care. Do they have cooks or chefs that can make meals that are much more tasty? Do they take residents out on field trips to area restaurants and shopping? Is there an exercise program? Do they have outdoor areas that they can access on their own? All of these things give them back choices. Having access to the outdoors is rare in a facility that deals with memory care but it is also a good sign that the facility knows the importance of such a need and provides for it.

Ask if there are additional licenses that will allow residents to age in place. Aging in place is especially important to those with memory issues so as not to disrupt their environment. It is also more cost effective than having to go to a skilled facility which tends to be twice as much.

Finally when you have narrowed down the search, ask around for the overall reputation of the facility in the surrounding area. Ask Doctors, the Alzheimers Association, and the local senior center just to name a few.